We initiated a large-scale study evaluating the effects of smoking cessation counseling delivered to patients admitted for acute (emergency) Myocardial Infarction (MI) or elective Peripheral Vascular Surgery (PVS) at Strong Memorial Hospital. The study identifies and tracks consecutively admitted cigarette smoking patients immediately upon admission. Patients are recruited into a study entitled "Recovery From Heart Attack or Vascular Surgery" that is portrayed as exclusively observational in nature. Subjects are told the ostensible purpose of the study is to document personal, medical, emotional, and lifestyle changes that characterize recovery from cardiovascular disease (CVD). Within two days of admission, informed consent is obtained, after which all patients undergo a preliminary screening by interview and questionnaire assessment. Patients are then randomized into one of three experimental conditions: (1) Early cessation counseling; (2) Late cessation counseling; or (3) Usual care. Smoking cessation counseling is presented to study patients as a standard component of hospital care of CVD. Using this methodology, we have successfully recruited consecutively admitted patients who display all levels of motivation for smoking cessation. 33 PVS and 22 MI patients were recruited in the first six months of data gathering. This rate of subject recruitment is lower than initially anticipated, apparently due to fewer available eligible patients. Consequently, plans have been made to recruit subjects from a second pool of patients at a nearby affiliated hospital in an effort to nearly double the recruitment rate. With this increased recruitment effort, we anticipate achieving our initially proposed subject recruitment goal. We will perform preliminary analyses on in-hospital cessation rates and the available long-term (one-year) follow-up.